J Korean Med Sci.  2018 Sep;33(36):e241. 10.3346/jkms.2018.33.e241.

Characteristics of Korean Patients with Polymyalgia Rheumatica: a Single Locomotive Pain Clinic Cohort Study

• Do JG
• Park J
• Sung DH

• KMID: 2419377
• DOI: http://doi.org/10.3346/jkms.2018.33.e241

Abstract

BACKGROUND
Polymyalgia rheumatica (PMR) is a common systemic inflammatory disease of the elderly; however, the clinical characteristics and therapeutic response of PMR in Korea have been rarely studied.
METHODS
We reviewed the medical records of 54 Korean patients diagnosed with PMR between January 2009 and February 2017 in a locomotive pain clinic of one tertiary referral hospital. We analyzed epidemiologic and clinical characteristics, therapeutic responses, and prognostic factors for remission-failure at one-year after oral prednisolone treatment.
RESULTS
In 54 patients with PMR, 32 (59.3%) were female. The average age at diagnosis was 65.0 ± 10.5 years. Duration of symptoms before diagnosis was 8.1 ± 8.6 months. All patients had shoulder pain (54 patients, 100.0%); 49 patients (90.7%) had hip girdle pain, while 19 patients (35.2%) had peripheral joint pain. Four patients (7.4%) were accompanied by the giant cell arteritis (GCA). There was no seasonal preference for symptom development. Only 19 patients were diagnosed with PMR at initial symptom presentation. At one-year follow-up after oral prednisolone treatment, the remission rate was 35.3% (12/34). Multivariate analysis showed that history of relapse (odds ratio, 6.81; 95% confidence interval, 1.035-44.804) was a significant predictor of remission-failure.
CONCLUSION
The rate of remission (35.3%) after oral prednisolone treatment was similar to previous reports in western countries; and GCA is not a rare condition in Korean PMR patients. Misdiagnosis of PMR is common, and heightened consideration for PMR is needed in elderly patients who present inflammatory features of bilateral shoulder pain.

Keyword

Polymyalgia Rheumatica; Giant Cell Arteritis; Prednisolone; Treatment Outcome

MeSH Terms

Aged
Arthralgia
Cohort Studies*
Diagnosis
Diagnostic Errors
Female
Follow-Up Studies
Giant Cell Arteritis
Hip
Humans
Korea
Medical Records
Multivariate Analysis
Pain Clinics*
Polymyalgia Rheumatica*
Prednisolone
Recurrence
Seasons
Shoulder Pain
Tertiary Care Centers
Treatment Outcome
Prednisolone